Pennsylvania has now seen a sixth measles associated death in the state in Franklin County.

According to the Franklin County Coroner’s Office, a 39-year-old woman who had multiple underlying health conditions, including a previous measles infection that was treated is the latest case.

This meets the definition set forth by the Pennsylvania Department of Health for a measles-associated death.

The six deaths have been reported from the following four counties: Lancaster County – 3 deaths (including two infants), Mifflin County (1), Jefferson County (1) and Franklin County (1).

As of October 9, Pennsylvania health officials have reported 1,136 confirmed measles cases, the most in the country.